Basic Information
| Provider Information | |||||||||
| NPI: | 1316558810 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAPPAS | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | CATHERINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1925 HAYES AVE | ||||||||
| Address2: | |||||||||
| City: | SANDUSKY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448704737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195575177 | ||||||||
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| Practice Location | |||||||||
| Address1: | 292 BENEDICT AVE | ||||||||
| Address2: | |||||||||
| City: | NORWALK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448572374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196633737 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2020 | ||||||||
| LastUpdateDate: | 06/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 101YA0400X | LCDCIII.162348 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.